The Missing Link Between Coffee Consumption and AKI–Water

Abstract

Using data from the Atherosclerosis Risk in Communities Study, Tommerdahl et al.,1Tommerdahl K.L. Hu E.A. Selvin E. et al.Coffee consumption may mitigate the risk for acute kidney injury: results from the atherosclerosis risk in communities Study.Kidney Int Rep. 2022; 7: 1665-1672https://doi.org/10.1016/j.ekir.2022.04.091Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar recently published in KI Reports findings supporting an inverse association between self-reported daily coffee consumption and incident acute kidney injury (AKI). The authors enrolled a large sample consisting of 14,207 middle-aged and older adults (45–64 years) and adjusted for several covariate factors that may influence the results (e.g., age, sex, race, smoking status, physical activity level, alcohol consumption, etc.). Following adjustments, the authors showed a dose-dependent risk reduction for AKI, in that those who consumed 2 to 3 cups per day of coffee showed the lowest risk of AKI during a hospital stay and drinking any amount of coffee was associated with an 11% reduction of developing AKI. The mechanistic underpinnings of these results were attributed to the potential benefits of caffeine or bioactive compounds in coffee on renal function. However, no discussion was provided on the relationship between fluid balance and renal health, despite a key nutrient of coffee beverages being water. Given that hospitalized patients presenting with fluid deficits or dehydration exhibit a 4-fold greater likelihood of developing AKI, compared to well hydrated patients,2El-Sharkawy A.M. Devonald M.A.J. Humes D.J. et al.Hyperosmolar dehydration: A predictor of kidney injury and outcome in hospitalised older adults.Clin Nutr. 2020; 39: 2593-2599https://doi.org/10.1016/j.clnu.2019.11.030Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar we believe further consideration of the influence daily fluid intake on AKI is warranted in interpretating the results by Tommerdahl et al.1Tommerdahl K.L. Hu E.A. Selvin E. et al.Coffee consumption may mitigate the risk for acute kidney injury: results from the atherosclerosis risk in communities Study.Kidney Int Rep. 2022; 7: 1665-1672https://doi.org/10.1016/j.ekir.2022.04.091Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar For instance, in the USA, greater than 95% of adults aged from 51 to 70 years have poor drinking habits coupled with a greater than 4-fold likelihood of developing a chronic disease within 3 to 6 years.3Stookey J.D. Kavouras S.Α. Suh H. Lang F. Underhydration is associated with obesity, chronic diseases, and death within 3 to 6 years in the U.S. Population aged 51–70 years.Nutrients. 2020; 12: 905https://doi.org/10.3390/nu12040905Crossref PubMed Scopus (20) Google Scholar Mechanistically, chronic low fluid intake or hypohydration stimulates an increase in arginine vasopressin, which is associated with elevated risk of chronic kidney disease.4Tasevska I. Enhörning S. Christensson A. et al.Increased levels of copeptin, a surrogate marker of arginine vasopressin, are associated with an increased risk of chronic kidney disease in a general population.Am J Nephrol. 2016; 44: 22-28https://doi.org/10.1159/000447522Crossref PubMed Scopus (36) Google Scholar Stated otherwise, chronically elevated arginine vasopressin may signal a hemodynamic frailty phenotype, resulting in reduced renal resiliency and increased plasma hypertonicity and opportunity for injury.5Docherty N.G. Delles C. D’Haese P. et al.Haemodynamic frailty-a risk factor for acute kidney injury in the elderly.Ageing Res Rev. 2021; 70: 101408https://doi.org/10.1016/j.arr.2021.101408Crossref PubMed Scopus (6) Google Scholar Taken together, it is biologically plausible that because daily fluid intake was not adjusted for, and the inherent limitations of varying caffeine content of coffee beverages, the benefits of self-reported daily coffee consumption on AKI development in hospitalized adults may be indicative of adequate fluid consumption behaviors and thus reduced vasopressin renal burden and AKI development. Coffee Consumption May Mitigate the Risk for Acute Kidney Injury: Results From the Atherosclerosis Risk in Communities StudyKidney International ReportsVol. 7Issue 7PreviewCoffee is one of the most frequently consumed beverages worldwide and has been found to have a wide assortment of health benefits. Although habitual coffee consumption is associated with a lower incidence of chronic kidney disease, an association between coffee and acute kidney injury (AKI) has not yet been revealed. Full-Text PDF Open AccessResponse to Letter to the Editor Entitled “The Missing Link Between Coffee Consumption and AKI – Water”Kidney International ReportsVol. 7Issue 11PreviewWe appreciate the interest of Yates et al. in our manuscript exploring the relationship between daily coffee consumption and incident acute kidney injury.1 In their letter, the authors insightfully identify water consumption due to coffee ingestion as a potential modifier of hydration status and thereby kidney function. Full-Text PDF Open Access